AccountId: 011433970860
ContactId: 8c66e4e2-c0da-4279-b1a2-ca73828a0528
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1044979 ms
Total Talk Time (AGENT): 341472 ms
Total Talk Time (CUSTOMER): 294886 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/8c66e4e2-c0da-4279-b1a2-ca73828a0528_20250501T18:47_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. This is Memory and customer service. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, this is [PII]. How are you?
[AGENT][NEUTRAL] I'm good, Ms. [PII]. How are you?
[CUSTOMER][NEUTRAL] Good. I, I was wondering if it was possible that I could speak to a supervisor or a manager, please?
[AGENT][NEUTRAL] OK, uh, I'll need a little bit of information first, uh, Ms. [PII], to get you to the right person, um, can you give me a little bit of information on what's going on?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, yes. This is something that's been going on for a long time. I, I had, um, well, first of all, we're all insured under my husband as a family plan, and I don't know if I need to give you my um group number or the outpatient benefit number. Does that help?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, yes ma'am, the group number will be fine and before we get started though, just in case we get disconnected, what's the phone number I can reach you back at?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK perfect and what's the group number?
[CUSTOMER][NEUTRAL] [PII] 23143.
[AGENT][NEUTRAL] OK, let me pull that group up. Hold on just a second.
[AGENT][NEUTRAL] Alright. 23143. And what's your husband's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me find it on here.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] All right, I was able to locate a [PII]. Can you verify his date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's today is his birthday.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Oh, well, tell him that [PII] wishes him a happy birthday.
[CUSTOMER][NEUTRAL] I will.
[AGENT][NEUTRAL] And um what is [PII]'s address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and uh can you also verify your phone number on the account?
[CUSTOMER][NEUTRAL] Um, well, my my number is [PII].
[AGENT][NEUTRAL] That's not the number we have on the account. Maybe it's his number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm, no, that's not it either. This one ends in [PII].
[CUSTOMER][NEUTRAL] No, he's got another number. Hold on, he's got another number for his, um, work. Hold on. Let me just, I don't know by memory I have to kind of look it up. Hold on, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] No problem, take your time.
[CUSTOMER][NEUTRAL] You don't call this number myself. I don't call it. It's in my phone, and Nova. OK, it's [PII].
[AGENT][NEUTRAL] Well, that's not it either.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Huh, well, he doesn't have any other number. He doesn't have any other number that I know of.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This one ends in [PII] so that doesn't sound familiar to you?
[CUSTOMER][NEUTRAL] 0, [PII]. That was, wow, that was from where we lived um six years ago. We lived in [PII] for 20 years. It was [PII].
[AGENT][POSITIVE] That's it, yes, ma'am. Thank you for verifying that. Um, we can get that updated.
[CUSTOMER][NEUTRAL] Yeah, we moved, we moved, yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, we moved, um, uh, how many years ago, 5.5 years ago we moved from [PII] to um, to [PII], so we no longer have that. That, that was, that used to be our old home line.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] All right, Ms. [PII]. Is Mr. [PII] available right now?
[CUSTOMER][NEUTRAL] Nope, he's not right next to me. I'm calling from home and he's at work.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we can get that updated. I just need permission from him to make changes on the policy so just whenever y'all get a chance where y'all are together, uh, just give us a call back and we'll update that, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] Alright, so now that I've got the information and I have verified the account, um, tell me what's going on.
[CUSTOMER][NEUTRAL] So, um, multiple times. I'm sure there should be some kind of documentation that you could see in our account. I've called multiple times, spoken to multiple representatives regarding a bill, uh, for a service that I had done back in [PII]. It was actually the date of service was [PII]. It was an MRI of the abdomen. I had it done at daycare outpatient imaging.
[CUSTOMER][NEUTRAL] And um I received a bill from them saying that uh you know I owed $500 which is the copay for my major medical but I always tell them, please send it to APL or secondary because I know they cover $200 per day of outpatient imaging and usually they send it and it usually gets paid without a problem. I don't know what happened uh with this one from [PII].
[CUSTOMER][NEUTRAL] Um, somehow the payment that was sent out, it was sent probably to the wrong address. I don't know who, how, how that happened.
[CUSTOMER][NEGATIVE] Um, but you, APL kept telling me they sent it. Uh, Baycare kept saying they did not receive it. APL finally verified it was never cashed by Baycare. Bay Baycare said please issue another one. I called back the APL another time. They said they were going to issue a new, a new payment. Um, they said it would take, I think it was 7 to 10 business days.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Uh, it's been way more than 7 to 10 business days. I get again another, another notice from Daycare that they still, we, you know, I still owe the money. So I called them up to see. They said they still have not received it, and I'm talking, this has been more than a month ago that I spoke to the representative who promised me that it would be resent to Baycare. So this is where I'm at. I'm, this is why I'm kind of like I'd like to speak to a supervisor. I've spoken to so many representatives and I'm not getting anywhere.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Not that I, not that I don't trust that you could help me, but you would understand my frustration that this has been going on for a long time now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am, I understand. I do apologize that you're going through all of that. I do see um where the claim it looks like the claim was reprocessed in March. um I'm not in claims so I don't really know what all this is on this screen, but I do see it. um, let me see if I can get a supervisor on the line for you. um, would you mind holding just a moment?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] No, not at all.
[AGENT][NEUTRAL] Alright, Ms. [PII], uh, well, hold on just a moment let me see if I can get somebody on the line for you, OK?
[CUSTOMER][NEUTRAL] Yes, yes, and I also asked Daycare to give me the address where this payment needs to be sent, um, so that maybe it's an address issue. I don't know, so I, I have an address that I can compare to see if it was sent to the right place.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK perfect yes ma'am the uh someone in claims should be able to verify that for you I'm gonna see if I can get a supervisor in claims to talk with you about it OK?
[CUSTOMER][POSITIVE] I appreciate it. Thank you.
[AGENT][NEUTRAL] No problem, Ms. [PII]. Just one second, OK?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Ms. [PII].
[CUSTOMER][NEUTRAL] Yes, I'm here.
[AGENT][NEUTRAL] Hi thank you for holding so my supervisor is in a meeting um so what I can do is I'm gonna have to transfer you to our care team. Our care team can then escalate your call further um if needed. I, uh, do apologize that it will be uh little bit of transferring but that's probably gonna be the only way I can get you to someone.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, right now since my manager since my supervisor is in a meeting, is that OK?
[CUSTOMER][NEUTRAL] Uh, yeah, I guess if that's the only choice I have.
[AGENT][NEUTRAL] Alright, Ms. [PII], hold on just a moment. I just wanted to let you know what was going on. I'm gonna get somebody on the care team on the line for you and explain what you're calling about and give them all your information, OK? So it'll be just a minute.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] in customer service. How are you?
[CUSTOMER][POSITIVE] Good how are you?
[AGENT][NEUTRAL] I'm good. Um, so I have a, um, insured on the line. Well, actually it's the spouse, um, she is calling regarding a claim payment.
[AGENT][NEUTRAL] Um, she was requesting a supervisor. I tried the escalations chat and teams, but [PII] is in a meeting and unavailable to get on the call, so she told me to transfer to care team and y'all can assist her if it needs to be sent on to um claim support.
[CUSTOMER][NEUTRAL] You have the policy number?
[AGENT][NEUTRAL] It is 169.
[AGENT][NEUTRAL] 941 9.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That is the policy that the claim is under.
[CUSTOMER][NEUTRAL] Was the claim for sale or?
[AGENT][NEUTRAL] Yes, the claim is for [PII]. Data service is 10-9-2023.
[CUSTOMER][POSITIVE] Thank.
[AGENT][NEGATIVE] So she's calling because she states that she's talked to um service reps many times and that the check was issued previously to the provider. The provider said they never got it. She called in we told her that it had never been cashed, so we reissued a new check and now the provider is calling her again telling her she still owes the money um because they haven't received the check from us.
[AGENT][NEGATIVE] Um, so she wants to verify where the check is being sent. She has an address to double check it against and all that, so she's just a little upset that she keeps having to go through this.
[CUSTOMER][NEUTRAL] OK, uh, did you get what claim number it was? It looks like there's a couple duplicates. Let's see. Yeah, well, it looks like, OK, I see it, got it.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, I was gonna say no, I don't know anything about the claim numbers. I got you a data service though 10-9-2023, um, and her callback number is um [PII].
[CUSTOMER][POSITIVE] Appreciate it.
[AGENT][NEUTRAL] 0440.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] All right. Well, are you ready for her?
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][POSITIVE] All right, here she comes. Thank you so much. Have a good day.
[CUSTOMER][POSITIVE] Thank you, you too.
[CUSTOMER][NEUTRAL] Hi Ms. [PII], this is [PII] on the care team um, memory had explained.